Provider Demographics
NPI:1598297830
Name:HALE, TORI
Entity Type:Individual
Prefix:
First Name:TORI
Middle Name:
Last Name:HALE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TORI
Other - Middle Name:
Other - Last Name:OWENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3625 N ANKENY BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-4604
Mailing Address - Country:US
Mailing Address - Phone:515-965-4660
Mailing Address - Fax:515-446-2765
Practice Address - Street 1:3625 N ANKENY BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-4604
Practice Address - Country:US
Practice Address - Phone:515-965-4660
Practice Address - Fax:515-446-2765
Is Sole Proprietor?:No
Enumeration Date:2017-03-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002379225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist